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[Editorial] Examining humanitarian principles in changing warfare  Voir?

Violence in war must have a limit. Those who are not participating in the hostilities should be protected to prevent war from sinking into barbarity. Today, this is safeguarded by international humanitarian law (IHL), of which the cornerstones are the four Geneva Conventions of 1949 and its Additional Protocols. IHL provides for the wounded and sick to be collected and cared for by the warring faction that has them in their power, and for them to receive timely medical care. Traditionally, those entering into conflict could be expected to uphold these laws.

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[Editorial] What's next for Indigenous health in Australia?  Voir?

Last week, the independent Close the Gap Campaign Steering Committee released a 10 year review of the government's Closing the Gap Strategy, ahead of the annual report. The 2008 Council of Australian Governments' Closing the Gap Strategy was developed following their signing of the Close the Gap Statement of Intent. This statement was meant to holistically tackle the social determinants of health inequality with targets in health, education, and employment, and represented a watershed moment, aspiring to secure health equity for Aboriginal and Torres Strait Islanders by 2030.

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[Editorial] Asthma in US children  Voir?

Around 6 million children in the USA are affected by asthma, making it the most common chronic lung disease in childhood. Last week, the US Centres for Disease Control and Prevention (CDC) published their monthly Vital Signs report, which analyses asthma data from the 2001–16 National Health Interview Survey for children aged 0–17 years. Asthma diagnosis was limited to adult proxy responses to two questions: “Has a doctor or health professional ever told you that [your child] had asthma?”, and “Does [your child] still have asthma?”

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[Comment] Acalabrutinib in mantle cell lymphoma  Voir?

Mantle cell lymphoma is a rare, distinct subtype of non-Hodgkin lymphoma, with a disparate clinical course that varies from indolent at times to frequently aggressive. No standard of care exists; most patients relapse and ultimately die as a result of their disease. Notable strides in the past few years, however, have ushered an era of unprecedented progress, with swift approval of new therapies from a variety of drug classes. One such drug that has catapulted to prominence is ibrutinib, the first-in-class, irreversible inhibitor of Bruton tyrosine kinase (BTK), a crucial component of the B-cell-receptor signalling pathway that is implicated in the pathogenesis of mantle cell lymphoma.

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[Comment] Rifampicin for Staphylococcus aureus bacteraemia: give it ARREST  Voir?

Although Staphylococcus aureus bacteraemia is both common and potentially lethal, clinical decisions involving its treatment remain largely unencumbered by high-quality data.1 With the ARREST multicentre, randomised, double-blind, placebo-controlled trial, Guy Thwaites and colleagues2 have contributed high-quality evidence and addressed an unresolved question involving the role of adjunctive rifampicin in treatment regimens for patients with S aureus bacteraemia.

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[Comment] Improving access to psychological therapies in England  Voir?

Most people with mental illness worldwide receive no treatment at all.1 The number benefiting from effective treatment is even fewer—eg, as low as one in six people with major depression receive effective care in high-income countries, and one in 27 people in low-income or middle-income countries.2 For mild-to-moderate depression, the treatments of choice are psychological therapies.3,4 Are there any examples of a health-care system successfully scaling up evidence-based practice for such common mental disorders? Yes: evidence is emerging that the Improving Access to Psychological Therapies (IAPT) programme in England fits this bill as reported by David M Clark and colleagues in The Lancet.

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[Comment] Amending the EU Withdrawal Bill: a safeguard for health  Voir?

Detailed analyses of the health consequences of Brexit have focused on its negative effects on the UK's National Health Service, food security, international cooperation to combat threats to health, medicines regulation, and medical research.1 Faced with this depressing picture, it is natural to seek any glimmer of hope. Could there be any opportunities to improve health? The answer, invariably, is that leaving the European Union (EU) could allow the UK to go beyond existing European policies to strengthen protection in public health—eg, by introducing traffic light labelling on food or implementing stricter environmental standards.

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[Comment] Making sense of the latest evidence on electronic cigarettes  Voir?

In the UK, 2·85 million people (5·7% of adults) regularly use electronic cigarettes (ECs), almost all of whom are smokers or ex-smokers.1 Prevalence of EC use is similar in the USA2 but is lower in other European Union (EU) countries (average 2%).1 ECs produce an estimated 18 000 additional long-term ex-smokers in England each year;3 a recent update suggests that figure might be as high as 57 000.1

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[Comment] Primary care research: a call for papers  Voir?

To mark the 40th anniversary of the Alma-Ata Declaration, The Lancet will dedicate the issue of Oct 20, 2018, to primary care and related themes. While we welcome submissions on all aspects of primary care at all times, and across all Lancet titles, this call for papers is particularly aimed at researchers in primary care settings.

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[Comment] Offline: Apostasy against the public health elites  Voir?

“Epidemiology is built on a history of convincing experiments…We need to get better at using randomised controlled trials as knowledge translation in the public health field”, wrote Anne Cockcroft last year. Who could disagree? The centrality of randomised evidence is firmly established for evaluating interventions and their application in clinical medicine. The same is true in public health. But any clinician or public health practitioner knows that there is more to evidence than the results of a precious randomised trial.

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[World Report] CDC faces leadership changes, potential spending cuts  Voir?

The CDC has indicated it will reduce its foreign presence, and proposed budget cuts make some fear its core functions are threatened. Susan Jaffe, The Lancet's Washington correspondent, reports.
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[World Report] Yemeni health under relentless pressure  Voir?

Renewed calls for funding, reports of increasing conflict, and the ongoing blockade of the Red Sea ports draw the picture of a worsening humanitarian situation in Yemen. Sharmila Devi reports.
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[World Report] End of a cholera epidemic in South Sudan declared  Voir?

An announcement on Feb 7 declared the end of a cholera epidemic in South Sudan. Talha Burki reports on controlling an epidemic in a country in the midst of civil war.
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[Perspectives] Schizophrenia  Voir?

Dementia praecox, dementia paranoides, catatonia, hebephrenia, stupefaction—just the terms historically associated with schizophrenia could fill up a short essay on the subject. The contentious and surprisingly short history of this diagnosis draws out some of the most difficult questions in psychiatry. Is schizophrenia a natural entity, awaiting objective description, or does it emerge from a shifting intersection of contexts? Is good practice a matter of grouping disorders into broad categories based on underlying resemblances, or does accurate diagnosis depend on breaking these generalisations down into lists of specific symptoms?

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[Perspectives] Life behind bars  Voir?

There's something of a shock in store for anyone who researches the infamous Newgate Prison in London, UK. In place of its reputation for cruelty and Gothic gloom, eyewitness reports and statistics suggest that life inside could be more wholesome than outside, for an ordinary, poor Londoner, with three meals a day, ale, clean bedding, the chance to exercise, and unlimited visits from friends and relations.

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[Perspectives] Gabriel Leung: working for a healthier Hong Kong  Voir?

In 2008, when he was a professor in the School of Public Health at the University of Hong Kong (HKU), Gabriel Leung was invited to join government service as Hong Kong's Under Secretary for Food and Health. As an academic, he was accustomed to offering policy advice: to being, as he puts it, an armchair critic. “If you're given the opportunity to practise what you preach and you turn it down”, he points out, “you have very little credibility in remaining an armchair critic”. He took the job. “As a public health physician”, he adds, “your form of clinical practice is doing public health in the real world”.

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[Perspectives] Medical 3D printing and the physician-artist  Voir?

It was psychologically impossible to prepare for the first patient I met who had catastrophic facial deformity. Medical training helped me respond to his sensory defects: sight, sound, smell, and taste. However, when one person meets another, we connect via, and then later recognise, one another's face. When I met that first patient—one of many wounded soldiers with severe facial injuries—I was challenged to help artfully repair the damage. Had the injury occurred in the mid-20th century, surgery would have been greatly limited by the paucity of options in plastic surgery.

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[Obituary] Anna Mae Hays  Voir?

US Army nurse and first female general in US Armed Forces. She was born in Buffalo, NY, USA, on Feb 16, 1920, and died following a heart attack in Washington, DC, USA, on Jan 7, 2018, aged 97 years.
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[Correspondence] Dengue vaccination: a more balanced approach is needed  Voir?

Media reports have cast doubt on the safety of dengue vaccination, resulting in the suspension of school-based immunisation programmes in the Philippines.1 The main concern about the vaccine is the risk of severe disease in children naive to dengue virus. Although these concerns are justified, it is important to consider this risk in the context of the wider population and to consider the public health value of dengue vaccination for the prevention of a disease that affects 400 million people annually, mostly in developing countries.

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[Correspondence] Germany's contribution to global health  Voir?

4 years after the adoption of Germany's first global health strategy,1 an expansion of Germany's role in global health is being observed and praised.2 Despite being a “latecomer” in this field,2 a lot of achievements have been made over the past few years. The German Government's multilateral approach and its efforts to strengthen the global health architecture in general are highly appreciated, as are the efforts of WHO in particular. Germany's official development assistance for health has increased substantially between 2013 and 2015, but this increase was mainly due to the inclusion of costs for asylum seekers within Germany.

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[Correspondence] Germany needs to catch up in global health research  Voir?

It is encouraging to read about Germany's engagement with the wider world and that Germany is taking responsibility for global health issues on a level that has not been seen before. However, key issues are missing in the description of the German health system (the Bismarck model) and the expanding role in global health,1 which have to be addressed to allow a successful move into the new role.

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[Correspondence] Germany must invest in its global health academic workforce  Voir?

At the launch of The Lancet's Germany and health Series in Berlin, passionate calls were heard for Germany to assume a leadership role in global health. Unfortunately, we are faced with a large gap in Germany's global health education and research capacity1 after a long period of global health “infancy”,2 and “low prioritisation of global health in its universities' curricula”.1 Less than a third of health-related degree programmes in Germany offer any global health education,3 and most medical faculties score low for global health research and education, according to the Global Health University Ranking.

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[Correspondence] Germany's expanding role in global health  Voir?

In their Series paper on Germany's expanding role in global health (July 3, 2017, p 898),1 Ilona Kickbusch and colleagues draw attention to the country's fragmented public health infrastructure. The authors call for an enabling network or platform to build synergies between the major German institutions—eg, through a global health institute or think tank. Although this approach is consistent with an analysis of Germany's scientific academies,2 the success of a specialised global health institute with an international programme would ultimately also depend on a domestic public health knowledge base of high competency and sufficient capacity.

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[Correspondence] Germany's expanding role in global health  Voir?

In their Series paper, Ilona Kickbusch and colleagues1 criticise Germany's higher education sector preparedness for global health, citing Kaffes and colleagues.2 We agree with Kickbusch and colleagues' view but want to stress that progress has been made.
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[Correspondence] Germany's expanding role in global health – Authors' reply  Voir?

Germany's role in global health is expanding, as we outlined in our contribution to the recent Series on Germany and health.1 Manfred Wildner and colleagues rightly argue that this expansion requires a strong domestic public health sector, yet Germany's public health infrastructure is fragmented2 and in need of domestic investment.1 The kind of investment required remains an issue of debate. Wildner and colleagues call for a reconciliation of public health services focusing on infectious disease control, and revived academic public health focusing inter alia on health promotion.

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[Articles] Acalabrutinib in relapsed or refractory mantle cell lymphoma (ACE-LY-004): a single-arm, multicentre, phase 2 trial  Voir?

Acalabrutinib treatment provided a high rate of durable responses and a favourable safety profile in patients with relapsed or refractory mantle cell lymphoma. These findings suggest an important role for acalabrutinib in the treatment of this disease population.
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[Articles] Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial  Voir?

Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia.
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[Articles] Transparency about the outcomes of mental health services (IAPT approach): an analysis of public data  Voir?

Traditionally, efforts to improve mental health outcomes have largely focused on the development of new and more effective treatments. Our analyses show that the way psychological therapy services are implemented could be similarly important. Mental health services elsewhere in the UK and in other countries might benefit from adopting IAPT's approach to recording and publicly reporting clinical outcomes.

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[Review] Investment in child and adolescent health and development: key messages from Disease Control Priorities, 3rd Edition  Voir?

The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5–9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10–14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15–19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control.

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[Public Health] Evidence-based guidelines for supportive care of patients with Ebola virus disease  Voir?

The 2013–16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive care to patients admitted to Ebola treatment units.

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[Viewpoint] Saving an additional 100 million lives  Voir?

10 years ago, we suggested a way to prevent 100 million deaths from tobacco.1 That initiative, grounded on the WHO Framework Convention on Tobacco Control, led to the creation of the MPOWER technical package, which in the past decade has newly protected about 3·5 billion people with effective tobacco control strategies, reduced tobacco use prevalence substantially, and prevented 30 million deaths.2,3 As that work continues, today, along with global partners, we are launching a new cardiovascular health initiative—Resolve—to prevent an additional 100 million deaths globally.

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Dernière mise à jour : 21/02/2018 : 05:35


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